Individual provider Active NPI

Rebecca E Tenzer, MAT, MA, LCSW, CTTP

  • Social Worker
  • Chicago, IL
National Provider Identifier
1912431792
Registry record updated Jul 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
150015155 Issued in IL
Practice address
1416 W Belmont Ave
Chicago, IL 60657-0939
Phone
(773) 799-8966
NPI assigned
Apr 18, 2017
Last updated
Jul 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150015155 IL Primary

Addresses

Primary practice location

1416 W Belmont Ave
Chicago, IL 60657-0939

Mailing address

1416 W Belmont Ave
Chicago, IL 60657-0939
Phone (773) 799-8966

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 17, 2025 through Apr 17, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
150015155ILMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593648000000",
    "number": "1912431792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1416 W BELMONT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606570939",
            "telephone_number": "773-799-8966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1416 W BELMONT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606570939",
            "telephone_number": "773-799-8966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENZER",
        "first_name": "REBECCA",
        "middle_name": "E",
        "credential": "MAT, MA, LCSW, CTTP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-18",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150015155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.